Abstract: Pharmacogenetic determinants of opioid addiction maintenance treatment with buprenorphine in a Caribbean Hispanic Population Abstract: The opioid use disorder epidemic resulted in over 60,000 overdose deaths in the United States in 2017. Currently guidelines recommend a combination of pharmacologic maintenance treatment (usually with methadone or buprenorphine) and psychosocial treatment. Recently, the use of buprenorphine for opioid use disorder has increased dramatically, partly due to fewer barriers to administration when compared to methadone. Nonetheless, variability in patient response to buprenorphine may lead some patients to fail treatment. In addition to clinical characteristics such as sex and concurrent medications that affect patient variability in response to buprenorphine, genetic variability may be a factor in the complex phenotype of therapeutic response to pharmacotherapy for opioid addiction. Although specific pharmacogenes (OPRM1, OPRD1, UGT2B7, and CYP3A4) have been identified that may contribute to the response of buprenorphine, there is a paucity of data in Hispanic populations. This addressable oversight is of great concern, since it will tend to exacerbate existing healthcare disparities that already exist affecting Hispanics with regards to the treatment of addiction.This pilot project aims to better understand the pharmacogenetic variables which affect the individual patient?s clinical response to buprenorphine for the treatment of opioid use disorder. By measuring buprenorphine plasma levels and clinical indicators of treatment response, we will perform a candidate gene association study to better understand how relevant pharmacogenes affect outcomes in a Caribbean Hispanic population being treated for opioid use disorder. The long-term goal of this research is to develop Caribbean Hispanic-oriented DNA-guided approach to treatment for opioid use disorder.